Sr. Auto Resolution Team Lead Cypress Care
THIS JOB HAS EXPIRED Objective
Provide exceptional customer service to inbound and outbound calls to clients, while supervising a team of agents.
Essential Duties and Responsibilities
? Perform all the Auto Resolution Specialist (ARS) Auto tasks, answer phones, resolve issues with patient prescriptions, contact adjuster, etc.
? Streamline and develop processes and procedures with Auto Rx to gain efficiencies.
? Coordinate and strengthen internal process flows with the paper bill team to improve claim distribution and turnaround rates.
? Enhance lines of communication between Auto Rx and Cypress Care.
? Drive resolution for all prior authorizations with account managers for Auto claims with no response from the adjuster/NCM.
? Notify management and account mangers on any escalated issues relative to Auto claims or Auto Rx.
? Resolve any outstanding issues or concerns with Auto Rx.
? Schedule and participate in weekly meeting with Auto Rx and Cypress Care.
? Manage and maintain account receivables for Auto claims at appropriate levels.
? Verify coverage and eligibility with adjusters/NCMs for all claims.
? Delegate tasks to Auto Resolution Specialist (ARS) to ensure a balanced workload (i.e. assign referrals for new patients).
? Handle any pharmacy operations issues escalated by Auto Resolution Specialist (ARS).
? Regularly update and review Standard Operating Procedures with Auto Resolution Specialist (ARS) to ensure that everyone is aware of and adhering to procedures.
? Provide input for Auto Resolution Specialist (ARS) performance appraisals.
? Respond to emails sent to the firstname.lastname@example.org or email@example.com email address.
? Create process flows as needed for processes relating to the daily activities of ARS staff
? Assist Account Management team and Implementation team with any special requests
? Perform interviews for potential new employees
? Create and manage Auto Resolution Specialist (ARS) on call schedules.
? Assist in management of Auto Resolution Specialist (ARS) work schedules.
? Monitor Auto Resolution Specialist (ARS) call center performance and activity.
? Answer incoming calls in queue.
? Appropriately handling calls from patients, vendors, clients, adjusters and pharmacies
? Enter new referrals into Sequoia in a timely and accurate manner
? Enter new referrals into pharmacy processing application when necessary
? Keep accurate notes in Sequoia and pharmacy processing application regarding patients
? Contact adjusters for rejects and & Rx override approvals
? Establish authorized and unauthorized physicians in pharmacy processing application
? Establish authorized and unauthorized prescriptions in pharmacy processing application
? Appropriately follow up on all referrals to ensure completion and accuracy
? Stay current on ALL Cypress Care policies, procedures and applications
? Other tasks as directed by the Company from time to time
? Assisting other departments with various data related tasks
? Please note that this task list is subject to change based on the needs of the business. You may be asked to perform tasks that are not expressly defined on this job description
? Proficient in Microsoft Office, including Word, Excel, Project, and Outlook
? Technical aptitude to review and analyze various file formats
? Solid presentation and public speaking skills
? Strong interpersonal and written communication skills
? Effective time management
? Ability to navigate at all levels of internal and external management structures
? Skilled negotiator
? Strong decision making skills
? Exceptional problem solving skills
? Ability to lead, motivate and inspire
Work experience should include a minimum of 1 year in Auto Resolution Specialist (ARS) role.
High School Diploma or GED required.
Other key attributes
? Detail oriented
||Duluth, GA |
THIS JOB HAS EXPIRED